Stereotactic Radiotherapy in Recurrent Glioblastoma: A Valid Salvage Treatment Option

Area of Science:

• Neuro-oncology
• Radiation Oncology

Background:

• Glioblastoma (GBM) is an aggressive brain tumor with inevitable recurrence after standard treatment.
• Salvage surgery is the current standard, with other options including chemotherapy, biological agents, and re-irradiation.

Purpose of the Study:

• To evaluate the efficacy and safety of salvage stereotactic radiotherapy (SRT) for recurrent glioblastoma (GBM).

Main Methods:

• A retrospective review of 132 GBM cases treated between 2010 and 2018.
• Identified 42 recurrent GBM patients treated with salvage SRT using the CyberKnife robotic system.

Main Results:

• Patients treated with salvage SRT had a median overall survival of 30 months, significantly longer than those not treated with SRT (14 months).
• Median survival after SRT was 12 months, with 1- and 2-year survival rates of 48% and 9%.
• Time to progression after SRT was 5 months, with 6-month and 1-year progression-free survival rates of 50% and 22% respectively. Patients with recurrence >12 months had better survival.
• SRT was well-tolerated with no grade III/IV toxicity. Prior salvage surgery correlated with worse outcomes post-SRT.

Conclusions:

• Stereotactic radiotherapy (SRT) is a feasible and effective salvage treatment for recurrent glioblastoma (GBM).
• SRT demonstrates acceptable local control and provides a survival benefit for recurrent GBM patients.
• SRT is particularly beneficial for patients experiencing late recurrence (>12 months).